Congestive Heart Failure
Congestive Heart Failure is a condition where the heart's ability to pump the blood has become impaired. The heart keeps working, but it is working less efficiently. The heart's main job is to pump the right amount of blood to all parts of the body. The amount of blood pumped by the heart depends on your body's activities. For individuals with congestive heart failure, the body's need for oxygen-rich blood is not fully met. Fever, some illnesses and exercise will increase the body's requirements for blood.
Common causes of congestive heart failure include: coronary artery disease (narrowed arteries that supply the blood to the heart muscle); past heart attacks which have scarred heart tissue; high blood pressure; heart valve disease; disease of the cardiac muscle (cardiomyopathy); congenital heart defects; and infection of the heart (endocarditis, myocarditis, etc.)
These causes can affect the heart in one of three ways: (1) by reducing the strength of the heart's muscle to contract, (2) by limiting the ability of the heart chamber to fill with blood, or (3) by filling the heart's pumping chambers with too much blood.
What happens in congestive heart failure? When the heart doesn't pump as efficiently as it should, the blood slows down and less blood is pumped. The blood returning to the heart backs up in the veins forcing fluid from the blood vessels into tissues of the feet and legs. The swelling that results is call "edema".
The left side of the heart receives oxygenated blood from the lungs and then pumps the blood throughout the body. When the heart's left side isn't pumping effectively, blood backs up into the vessels of the lungs. Fluid may be forced out of the lung vessels into the breathing spaces causing shortness of breath, difficulty in breathing and coughing. This is called pulmonary edema.
The most common sign of congestive heart failure is shortness of breath. Shortness of breath, caused by fluid in the lungs, can occur during exercise or when resting. Sometimes shortness of breath comes on suddenly at night. Sometimes the person will cough up pinkish, blood-tinged phlegm. Another sign of congestive heart failure is the buildup of excess fluid in the body's tissues, causing edema of the legs and sometimes of the abdomen. Weight gain can result. Other symptoms can include tiredness and weakness.
Treatments for congestive heart failure will vary with the severity and cause of the failure, but treatment is geared to the reduction of symptoms - fatigue, shortness of breath and swelling. One of the most important aspects of treatment is adherence to a low-sodium diet. This will help diminish fluid retention and will decrease the heart's work. It is extremely important that people with congestive heart failure weigh themselves every morning to assess the retention of fluid in their body.
There are several types of medications that the doctor may order to treat congestive heart failure. One such medication is a water pill (diuretic). Diuretics help the body to rid itself of extra fluid and sodium. This helps to reduce the heart's workload making it easier for the heart to pump. A common effect of taking water pills, is the loss of potassium. Your doctor will let you know if dietary changes are enough to compensate for your potassium loss or if you should take a potassium supplement.
Another medication often prescribed is Digoxin. Digoxin is prescribed to increase the force of each heart beat. This results in more blood circulating through your body at a slower heart rate. Your doctor will let you know if you should take your pulse prior to taking your dose of Digoxin. Foods high in fiber may affect the absorption of Digoxin and should be eaten in moderation -- always consult your doctor before making any changes in your diet. Because Digoxin has a narrow range between therapeutic and toxic blood levels you should call your doctor if you experience any of the following symptoms: abdominal pain, anorexia, diarrhea, fatigue, headache, nausea, vomiting, visual disturbances, double vision and weakness.
Vasodilators may also be prescribed by your doctor to treat congestive heart failure. Vasodilators cause the blood vessels to expand, making it easier for blood to flow, thus reducing the heart's work. Some vasodilators work directly on the heart muscle and may keep the heart from getting larger and the disease from getting worse.
It is important that you follow the medical regime planned by you and your doctor. Prevention of complications is extremely important in maintaining your comfort. Be aware that anxiety, fever and infections may raise your blood pressure and heart rate increasing your body's requirement for blood. Monitor your weight everyday; unexplained weight gain often is an important early sign of congestive heart failure. Ask your doctor about pneumonia and influenza vaccinations, and limit your exposure to crowds and to people with colds and infections.